TABLE OF CONTENTS
CHAPTER ONE: INTRODUCTION
Background of the study
Motivation of the study
Objective of the study
Research methodology
Contribution to knowledge
Organisation of the rest of the thesis
CHAPTER TWO: LITERATURE REVIEW ON TELEMEDICINE
SYSTEM AND RELATED WORKS
Introduction to Telemedicine
History of Telemedicine
Review of E-Health
E-Health History
Overview of some existing telemedicine System
Telecardiology
Dermatology
Electronic medical records for rural health systems
Wristclinic
CHAPTER THREE: SYSTEM ANALYSIS AND DESIGN
Telemedicine system
Telemedicine system architecture
Implemented System description
Administrative module
Consultation module
3.3.2.1 Consultation/diagnosis
3.3.2.2 Remote Consultation
3.3.2.3 Test module
Referral module
Training module
Designing telemedicine system database
3.4.1 Entity Relationship Diagram (ERD)
3.5 Designing the healthcare enterprise memory
3.6 Strategic healthcare decision support services
3.7 Implementing the system database
CHAPTER FOUR: SYSTEM IMPLEMENTATION AND
PERFORMANCE ANALYSIS
System Implementation
4.1.1 System security and privacy
4.1.2 System Interface
4.1.3 Teleconsultation database result
Performance analysis
4.2.1 Software Analysis
4.2.2 Hardware analysis
4.2.3 Technical analysis
4.2.4 Interoperability
Challenges and implementation bottleneck
4.3.1 Organisational and cultural intertia
4.3.2 Technology and information change
4.3.3 Lack of IT funding and human resources
Training
4.4.1 Pro and cons training methods
CHAPTER FIVE: CONCLUSION AND RECOMMENDATIONS
Conclusion
Recommendations
Area of further research
References
Appendix A (Source code listing)
CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Telemedicine can be broadly defined as the use of information and telecommunication technologies to provide medical information and services at a distance. Telemedicine has existed long before the internet, some authors observed that telemedicine was broadly conceived even when the term was used almost three decades ago. Some of the first telemedicine reports were of group therapy (Withson, et. al., 1961), nursing interactions (Cunningham, et. al., 1978), education and training (Menolascino et. al., 1970), telemetry (Fuchs, 1979), televisits to community health workers (Straker, et. al., 1972), and home care (Mark, 1974), among other applications. In many cases, no physician was involved, and interactivity was not a necessary aspect of the processing.
The term Telemedicine is the delivery of medicine at a distance. The term is composed of the Greek word τελε (tele) meaning ‘far’, and medicine. Telemedicine may be as simple as two health professionals discussing a case over the telephone, or as complex as using satellite technology and video-conferencing equipment to conduct a real-time consultation between medical specialists in two different countries. It can also involve the use of an unmanned robot.
Telemedicine generally refers to the use of communications and
information technologies for the delivery of clinical care.
Telemedicine is most beneficial for populations living in isolated communities and remote regions and is currently being applied in virtually all medical domains.
Specialties that use telemedicine often use a “tele-” prefix; for example, telemedicine as applied by radiologists is called Teleradiology. Similarly telemedicine as applied by cardiologists is termed as telecardiology, etc.
The ability of telemedicine to facilitate medical care irrespective of distance and availability of personnel on site makes it attractive to both the public and private health sectors. Telemedicine allows better utilization of scarce medical personnel and resources. It enhances citizen’s equality in the availability of various medical services and healthcare despite geographical and economic barriers, at a lower cost. In particular, telemedicine may be seen as a valuable tool for providing much needed medical services to remote rural areas. It promises to enhance continued medical education of our young doctors, nurses and other healthcare practitioners in rural areas, both in training and in established practice(O. S.Adewale, 2004).
Healthcare system ranges from highly specialized urban areas, to small rural clinics in most part of underdeveloped and developing countries. The legacy of recent decades is an inappropriate distribution of health practitioners and expertise that are concentrated in major urban centers, while people living in rural areas have limited access to basic healthcare because of geographical isolation and poor public transportation.
Telemedicine is one form of advanced technology that may be part of the solution to a number of healthcare and education problems in most
underdeveloped and developing countries.
Therefore, in this thesis, a web-based medicine system is designed and implemented for Nigeria.
1.2 MOTIVATION OF THE STUDY
The third world countries are usually characterized by high population density. Nigeria for instance has an estimated population of about 120 million people. More than seventy percent (70%) of her populist reside in the rural areas with shortages of medical experts, and hospitals. Due to geographical isolation and lack of opportunities for medical experts, few available medical experts are often reluctant to serve in remote rural and poorer areas. As a result of this, people living in this remote rural and poorer areas have limited access to basic healthcare services and consequently receive lower quality of healthcare service compare to those living in urban areas where best equipped hospitals and medical experts are available. Patients living in these areas requiring the attention of healthcare practitioner to meet their needs must travel to distance healthcare centres, which is quite impossible due to the present state in medical emergences.
Therefore, there is the need to develop a web-based telemedicine system that will improve upon the quality of medical services, lower cost of delivering such service to the people in remote areas, and providing more up-to-date medical information to rural healthcare workers demarcated from the main stream of information awareness.
1.3 OBJECTIVE OF THE STUDY
The main objective of this work is to provide, develop and implement a telemedicine system, which will:
i) enhance citizen’s equality in the availability of various medical services and healthcare delivery despite geographical and economic barriers through the use of web-based telemedicine application.
ii) reduce direct and indirect cost (loss income), usually incurred as a result of moving patients from one geographical location to another in search of better and quality medical services.
iii) improve consultation and co-operation among various units of healthcare services in both special cases and primary care by bridging the distance between practitioners and specialists.
iv) provide opportunities for the healthcare practitioners to gain access to information that can aid in the diagnosis of patient’s healthcare conditions.
1.4 RESEARCH METHODOLOGY
A review of related literature was carried out. A web-based telemedicine system that would provide efficient and convenient methods for the remote rural healthcare workers and physicians located at the cities to collaborate with one another over patient’s cases was developed and implemented. Technological approach to the development of the system is based on apache as a web-server with extended capability for PHP scripting language and MySQL as a relational database.
1.5 CONTRIBUTION TO KNOWLEDGE
The need to develop a web-based telemedicine system that will improve upon the quality of medical services, lower cost of delivering service to the people in remote areas, and providing more up-to-date medical information to rural healthcare workers demarcated from the main stream of information awareness.
1.6 ORGANISATION OF THE REST OF THE THESIS
The rest of the thesis is structured as follows: in chapter two, we review telemedicine system generally and discussed its features and prospect as regards to the medical profession generally. Some related literature was also reviewed.
In the third chapter, we describe and design an automated system for the proposed telemedicine system.
In the fourth chapter, an implementation of the system designed is presented using PHP and MySQL.
In the chapter five, conclusion and recommendations were made.